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Get a Commercial Auto Quote

Get a Commercial Auto QuoteJennifer Haring2022-05-19T17:50:38-05:00

Thank you for your interest in receiving a quote from USA Truck Insurance. This form should only take about 5-10 minutes to complete. Don't worry if you don't have everything. You can always click the "Save and continue later" button below. We'll email you a private link to pick up where you left off.

MM slash DD slash YYYY
Which type of insurance are you looking for?*
Check all that apply.
Primary Insured Name*
Insured Date of Birth*
Can we text you?*

Business Information

Business Address*
Mailing Address*
Is this business affiliated with a franchise?

Additional Business Owners

Owner 2

2. Owner Name*
2. Owner Date of Birth*

Owner 3

3. Owner Name*
3. Owner Date of Birth*

Owner 4

4. Owner Name*
4. Owner Date of Birth*

Vehicles

Are all vehicles garaged at the business address?*
Are all vehicles titled in the name of the business?*

Vehicle 1

1. Does this vehicle have permanently attached equipment?

Vehicle 2

2. Does this vehicle have permanently attached equipment?

Vehicle 3

3. Does this vehicle have permanently attached equipment?

Vehicle 4

4. Does this vehicle have permanently attached equipment?

Vehicle 5

5. Does this vehicle have permanently attached equipment?

Vehicle 6

6. Does this vehicle have permanently attached equipment?

Drivers

Commercial License? (CDL)
Let's add 8 of your drivers now. We will contact you to get your additional drivers information.
Do any of your drivers take the vehicle(s) home at night?*

Driver 1

1. Name*
1. Date of Birth*
1. Commercial License? (CDL)
1. Hire Date

Driver 2

2. Name*
2. Date of Birth*
2. Commercial License? (CDL)
2. Hire Date

Driver 3

3. Name*
3. Date of Birth*
3. Commercial License? (CDL)
3. Hire Date

Driver 4

4. Name*
4. Date of Birth*
4. Commercial License? (CDL)
4. Hire Date

Driver 5

5. Name*
5. Date of Birth*
5. Commercial License? (CDL)
5. Hire Date

Driver 6

6. Name*
6. Date of Birth*
6. Commercial License? (CDL)
6. Hire Date

Driver 7

7. Name*
7. Date of Birth*
7. Commercial License? (CDL)
7. Hire Date

Driver 8

8. Name*
8. Date of Birth*
8. Commercial License? (CDL)
8. Hire Date

Underwriting

How are drivers paid?*
Which of the following is part of your driver screening/hiring process?*
Check all that apply
In the past 5 years have you, or any driver, been convicted of any of the following?
Check all that apply
Are drivers covered by workers comp?*
Do you haul for hire?*
Do you Barter Hire or Lease any drivers or vehicles out for others to use?*
Which party provides primary auto liability coverage?*
Do you Barter Hire or Lease any drivers or vehicles to haul under your authority?*
Are owner-operators subject to the same hiring, training, and equipment maintenance standards as company drivers?*
On what basis are vehicles and drivers leased?*
Do you require and get evidence that leased vehicles owners purchase non-trucking liability?*
We will need a copy of the lease agreement
Does your company allow any of the following practices?
Check all that apply

Primary Coverage Options

What coverages are you looking to have in place?*
Check all that apply

Underwriting

Do you need Federal Filings*
Note: For Federal Filings, an MCS 90 Endorsement is needed too.
Do you need State Filings?*
Is any part of your operation seasonal?
Does vehicle(s) have an ELD installed?
Does your business provide any of the following general services?*
Does your business generate revenue from any services other than trucking for hire?*
Have you ever changed your operating name?*
Do you operate under any other names currently?*
Do you operate as a subsidiary of another company?*
Have you purchased, sold, or applied for authority over the past 3 years?*
Have you ever lost, or had authority withdrawn, or have been/are under probation by any regulatory authority? (FHWA, PUC, etc.)*
Do you agree to report all newly hired operators?*
Do you agree to report all newly purchased or leased equipment?*

Commodities & Historical Counts

Commodities Hauled*

Please list all commodities you normally haul. Click the "+" sign to add more rows. Please limit "general freight" to 10%. Carriers ask for specific commodities.

% of all loads should add up to 100%.

Commodity Name
% of All Loads
 

Business Information Continued

Do you have employee(s)?*
Do you lease your employees?*
Do you use any subcontractors? (1099s)*
Do you have a written contract with your subs requiring them to name your business as Additional Insured and show proof every year?*
Do you employ mechanics?*
Any Warehouse Workers?*
Any Dispatch Workers?*

Building and Property Information

My business location is*
Do you need coverage for the building?*
Have you made any tenant improvements?*

Building Information

Has there been any updates to the roof, plumbing, or electrical?*

Business Description

Customer Data

Which industry standards do you comply with?*
Who manages you cybersecurity?*
Do you encrypt all stored or accessed personal data?*
How often do you backup your data*
How long do you retain those backups?*

Claims Information

Have you had any claims or losses in the last 5 years?*

Current Insurance

Has your business been cancelled or non-renewed in the last 4 years?*
Have you ever filed for bankruptcy?*
Do you have ANY business insurance currently?*
Expiration date of current policy*
Drop files here or
Accepted file types: pdf, Max. file size: 5 MB, Max. files: 10.

    Liability Limits (Optional)

    Do you need any Business Personal Property coverage?*
    Are you interested in Loss of Use / Business Income coverage?*

    Garage & Dealers Information

    What types of vehicles you service, repair, or sell?*
    Select all that apply
    Example: If you have 20 vehicles at any one time and each vehicle has an average value of $25,000 then you would want $500,000 in coverage.
    What parts and accessories do you sell over the counter?
    What are your security practices?*
    Where do you store customer's vehicles?*
    Where do you store keys to customer's vehicles?*
    Do you tow for hire?*

    Garage & Dealers Information

    List the percentage of the work you provide for each section below.

    Where work is performed. Total must equal 100%.
    % at Your Shop
    % at Customer's Location
    % Other

    0%

    Type(s) of work performed (in percent). Total must equal 100%.

    % Body/Paint
    % Brakes, Transmission or Suspension
    % Electrical
    % Mechanical
    % Muffler/Radiator
    % Oil Change
    % Roadside Assistance
    % Safety Inspection
    % Tires/Wheels
    % Tune Up
    % Wash/Detail
    % Welding
    % Other (Upholstery, frame work, body work, window tint, windows, cleaning trailer, stereo system, etc.)

    0%

    Do you provide any off-site services or mobile services?*

    Dealer Sales Questions

    Do you sell "salvage titled" vehicles?*

    Additional Insured Information (Optional)

    Do you have anyone that needs to be listed as Additional Insured?
    You may upload your additional insured documents using the upload field below.
    You may upload up to 10 PDF documents. If you have more documents you can send them to your agent after they contact you.
    Drop files here or
    Accepted file types: pdf, Max. file size: 10 MB, Max. files: 10.

      Additional Comments and/or Current Policy Upload (Optional)

      Drop files here or
      Accepted file types: pdf, Max. file size: 8 MB, Max. files: 5.

        Wrapping Up

        Consent*
        Like most insurance agencies, we use information from you and other sources, such as your driving and claims histories, insurance score, and other factors to calculate an accurate rate for your insurance. New or updated information may be used to calculate your renewal premium.
        Would you like to create a user account to manage your submissions?*
        Password*
        Authorized Person's Name*
        This field is for validation purposes and should be left unchanged.

        USA Truck Insurance Logo

        USA Truck Insurance

        10340 Alta Vista Rd, #100
        Fort Worth, Texas 76244
        Phone: 817-282-4666
        Secondary phone: 1-877-404-5778
        Fax: 817-282-4859
        Email: sales@theharingagency.com

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        DISCLAIMER: Informational statements regarding insurance coverage are for general description purposes only. These statements do not amend, modify or supplement any insurance policy. Read your policy or consult with your agent for details. Your eligibility for particular products and services is subject to final underwriting and acceptance by the insurance company providing such products or services.

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